Neoadjuvant Chemotherapy for Locally Advanced Breast Cancer Results in Alterations in Preoperative Tumor Marker Status

Piper, G. L.; Patel, N. A.; Patel, J. A.; Malay, M. B.; Julian, T. B.
December 2004
American Surgeon;Dec2004, Vol. 70 Issue 12, p1103
Academic Journal
Neoadjuvanl therapy followed by breast-conserving surgery has become an acceptable option for patients with locally advanced breast cancer. Although a distinct survival benefit has not been demonstrated using this approach, several questions have been raised following such therapy including its effects on receptor status and tumor markers. The current study retrospectively reviews estrogen receptor (ER), progesterone receptor (PR), and HER2-neu status in 55 consecutive patients treated by neoadjuvant chemotherapy. Preoperative and postoperative tumor markers were available for 43 of the 55 patients (78%). The pathologic complete tumor response rate (pCR) for this group was 19 per cent (8/43). Of those patients who did not achieve a pCR (n = 35), a change in tumor markers was seen in 25.7 per cent (9/35) of patients. When compared to a control group not undergoing neoadjuvant therapy, a significantly higher percent change in marker expression was noted in the neoadjuvant group (25.7% vs 5.9%, P = 0.046). ER, PR, and HER2-neu status remain important prognostic indicators for breast cancer. Tumor markers are useful in planning adjuvant therapy regimens. In this review, nearly 19 per cent of patients achieved a pCR. In patients not achieving a pCR, one in four patients had at least one change in tumor marker status. This study demonstrates the importance of establishing receptor and marker status prior to neoadjuvant therapy, as many patients will achieve a pCR and make tumor analysis impossible. Postoperative marker studies should be performed given the possibility of a change in status. The clinical relevance of this data will require further long-term follow-up. Until such data becomes available, caution should be considered when basing adjuvant therapy regimens on preoperative tumor marker studies alone.


Related Articles

  • Current and emerging quantitative magnetic resonance imaging methods for assessing and predicting the response of breast cancer to neoadjuvant therapy. Abramson, Richard G.; Arlinghaus, Lori R.; Weis, Jared A.; Xia Li; Dula, Adrienne N.; Chekmenev, Eduard Y.; Smith, Seth A.; Miga, Michael I.; Abramson, Vandana G.; Yankeelov, Thomas E. // Breast Cancer: Targets & Therapy;2012 Part 2, Vol. 4, p139 

    Reliable early assessment of breast cancer response to neoadjuvant therapy (NAT) would provide considerable benefit to patient care and ongoing research efforts, and demand for accurate and noninvasive early-response biomarkers is likely to increase. Response assessment techniques derived from...

  • Standardized Assessment of Ki-67 in Breast Cancer Patients Using Virtual Slides and an Automated Analyzer in Comparison to Central/Local Pathological Assessments. Yoshio Mizuno; Hiromi Fuchikami; Tsuneo Natori; Naoko Takeda; Yuko Inoue; Junichi Yamada; Hiroaki Abe; Hiroshi Seto; Kazuhiko Sato // Journal of Cancer Therapy;Feb2014, Vol. 5 Issue 5, p141 

    Purpose: To standardize the methods to measure Ki-67, there is an interest in automating the assessment of Ki-67. Therefore, we reviewed the possibility of introducing an automated analyzer to standardize the Ki-67 evaluation method. Methods: We retrospectively reviewed a clinical database of...

  • CDO1 Promoter Methylation is a Biomarker for Outcome Prediction of Anthracycline Treated, Estrogen Receptor-Positive, Lymph Node-Positive Breast Cancer Patients. Dietrich, Dimo; Krispin, Manuel; Dietrich, Jörn; Fassbender, Anne; Lewin, Jörn; Harbeck, Nadia; Schmitt, Manfred; Eppenberger-Castori, Serenella; Vuaroqueaux, Vincent; Spyratos, Frédérique; Foekens, John A.; Lesche, Ralf; Martens, John W. M. // BMC Cancer;2010, Vol. 10, p247 

    Background: Various biomarkers for prediction of distant metastasis in lymph-node negative breast cancer have been described; however, predictive biomarkers for patients with lymph-node positive (LNP) disease in the context of distinct systemic therapies are still very much needed. DNA...

  • SUPPORT AFTER BREAST CANCER: EVALUATION OF A SENIOR PEER COUNSELING TELEPHONE INTERVENTION. Crane-Okada, Rebecca; Mandile, Elizabeth; Mirzadehgan, Parisa; Mabry, Helen; Giuliano, Armando // Oncology Nursing Forum;Jan2007, Vol. 34 Issue 1, p252 

    Few studies address the effectiveness of support for older women during the stress-filled time between breast cancer surgery and initiation of adjuvant treatment, and none explore the use of senior peer counselors, who have the skills and life experiences to provide older adults with emotional...

  • Tumour markers: their use and misuse by clinicians. McGinley, Peter J; Kilpatrick, Eric S // Annals of Clinical Biochemistry;Nov2003, Vol. 40 Issue 6, p643 

    Background: Several guidelines exist on the appropriate use of serum tumour markers in the management of patients with cancer. This study audited tumour marker requesting against these guidelines in a busy teaching hospital over a 12-month period. Methods: All marker requests from 1 April 2001...

  • Prognostic value of micrometastases in sentinel lymph nodes of patients with breast carcinoma: a cohort study. P. D. Gobardhan; S. G. Elias; E. V. E. Madsen; V. Bongers; H. J. M. Ruitenberg; C. I. Perre; T. van Dalen // Annals of Oncology;Jan2009, Vol. 20 Issue 1, p41 

    Background: The prognostic meaning and thus indication for adjuvant therapy of lymphogenic micrometastases in breast cancer patients is still under debate. Patients and methods: From 1999 to 2007, 703 patients with cT1–2N0 breast cancer underwent surgery including sentinel lymph node...

  • Expressions of 10 genes as candidate predictors of recurrence in stage III colon cancer patients receiving adjuvant oxaliplatin-based chemotherapy. Kumamoto, Kensuke; Nakachi, Yutaka; Mizuno, Yosuke; Yokoyama, Masaru; Ishibashi, Keiichiro; Kosugi, Chihiro; Koda, Keiji; Kobayashi, Michiya; Tanakaya, Kohji; Matsunami, Toshio; Eguchi, Hidetaka; Okazaki, Yasushi; Ishida, Hideyuki // Oncology Letters;Aug2019, Vol. 18 Issue 2, p1388 

    Approximately 30% patients with stage III colon cancer (CC) develop local recurrence and/or distant metastasis, even if postoperative adjuvant chemotherapy with oxaliplatin plus 5-fluorouracil and leucovorin (5-FU/LV) has been completed. In the present study, molecular analysis was performed to...

  • Functional magnetic resonance: biomarkers of response in breast cancer. O'Flynn, Elizabeth A. M.; DeSouza, Nandita M. // Breast Cancer Research;2012, Vol. 13 Issue 1, p1 

    Functional magnetic resonance (MR) encompasses a spectrum of techniques that depict physiological and molecular processes before morphological changes are visible on conventional imaging. As understanding of the pathophysiological and biomolecular processes involved in breast malignancies...

  • Breast density change as a predictive surrogate for response to adjuvant endocrine therapy in hormone receptor positive breast cancer. Jisun Kim; Wonshik Han; Hyeong-Gon Moon; Soo Kyung Ahn; Hee-Chul Shin; Jee-Man You; Sae-Won Han; Seock-Ah Im; Tae-You Kim; Hye Ryoung Koo; Jung Min Chang; Nariya Cho; Woo Kyung Moon; Dong-Young Noh // Breast Cancer Research;2012, Vol. 14 Issue 4, p1 

    Introduction: Anti-estrogen therapy has been shown to reduce mammographic breast density (MD). We hypothesized that a short-term change in breast density may be a surrogate biomarker predicting response to adjuvant endocrine therapy (ET) in breast cancer. Methods: We analyzed data for 1,065...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics